Intensive educational programs were sponsored for both professionals and others who were immediately involved in action programs, as well as the general public. Similarly, a number of research and action-oriented projects in methods of prevention and control of induced abortion were initiated. For the purposes of this paper, a recent report of such a research experiment is selected for consideration (96). The report included the results of a 39-month contraceptive campaign, principally using intra-uterine devices (lUD's), which was aimed at reducing the rates of birth and induced abortion. The study was initiated in the western district of Santiago in 1964 and is still underway. The report covers the period from April 1964, through June 1967.
The program of contraceptive education started in both the hospitals and in the community at large. The contraceptive services included IUD insertions, which were done immediately or soon after an abortion or a delivery, as well as after menses for some women. Other methods were offered, but this report concentrates on the IUD program.
The number of women who accepted the pill totalled 432; those who accepted the IUD totalled 20,416 or approximately 18.5 percent of the total fertile women in the area. The birth rate dropped from over 40 per 1,000 population in 1964 to 28.7 in 1966. Although Viel had calculated this rate to be 73 percent of the preprogram rate in 1963, the curve indicated that the birth rate was already on the decline. Nevertheless, it is evident that this program further hastened fertility decline. So far, the program has had a most significant effect on induced abortion, calculated as a reduction from 31 to 50 percent.
From this and similar programs, the Chilean authors concluded that great effort and substantial expense is necessary to make general a widespread and effective program of contraception. One author has argued that at least 10 to 15 percent of the fertile women need to be protected in order to obtain a reduction in induced abortion and the birth rate (28).
The studies from Japan and Chile illustrate that the high rate of induced abortion does not respond immediately to the increasing availability of effective contraceptives. On the contrary, there appears to be a delayed reaction between contraceptive program effectiveness and abortion decline. Several reasons for the continued use of induced abortion during an intensive contraceptive program deserve mention.
During the stages when abortion is widely used, either legally as in Japan or illegally as in Chile, many women become "abortion minded." This attitude is a catalytic result of the modernizing influences which foster upward social mobility. Small family size is perceived as a prerequisite for fulfilling these aspirations. Because of the short supply or failure of contraceptives,